1. Technical Field
This disclosure relates to a clip advancing system for a surgical clip applicator.
2. Description of Related Art
Heretofore, it has been known to use surgical clips, for example of metal, to provide hemostasis and occlude tissue structures in a wide variety of surgical procedures. To this end, use has been made of various applicators.
One approach has been to deliver a clip from a clip magazine to between a pair of jaws in response to the closing of a pair of handles by a surgeon with a subsequent crimping of the clip by the jaws via a continued closing of the handles together. However, such a pre-firing arrangement of a clip may pose problems to a surgeon. First, if the applicator has been completely discharged of clips, the surgeon may not be able to readily determine that the applicator is empty. Second, should an applicator be fired while about a vessel without a clip being discharged, the vessel may become damaged to such an extent that a clip cannot be subsequently applied at that location of the vessel. Third, the surgeon may not be able to see a clip being positioned between the jaws during closing of the handles to ensure proper position on a vessel.
U.S. Pat. Nos. 4,616,650 and 4,624,254, both of which are hereby incorporated by reference, disclose a surgical clip applying apparatus having a pair of ring-like handles. The handles are squeezed to force jaws to move distally relative to the apparatus where they are forced together by a pair of inclined surfaces. A surgical clip between the jaws is thereby squeezed closed.
In laparoscopic procedures surgery is performed in the interior of the abdomen through a small incision and/or guide sleeve; more generally, in endoscopic procedures surgery is performed in any hollow viscus of the body, e.g., through narrow endoscopic tubes inserted through small entrance wounds in the skin. Laparoscopic and endoscopic procedures generally require that any instrumentation inserted into the body be sealed, i.e., provisions must be made to ensure that gases do not enter or exit the body through the laparoscopic or endoscopic incision as, for example, in surgical procedures in which the surgical region is insufflated. Moreover, laparoscopic and endoscopic procedures often require the surgeon to act on organs, tissues, and vessels far removed from the incision, thereby requiring that any instruments to be used in such procedures be both long and narrow.
Because endoscopic procedures are more common than laparoscopic procedures, to the extent the present disclosure contemplates endoscopic and/or laparoscopic procedures and apparatus, the disclosure shall speak in terms of endoscopic procedures and apparatus. However, use herein of terms such as "endoscopic", "endoscopically" and "endoscopic portion", among others, refer generally to instruments having elongated and relatively narrow operating portions for inserting into a cannula or a small wound in the skin and should not be construed to limit the present disclosure to an apparatus for applying surgical clips only in conjunction with an endoscopic tube. To the contrary, it is believed that "endoscopic" apparatus set forth in the present disclosure may find use in any procedure where access is limited to a small incision, including, but not limited to, laparoscopic procedures.